Real-World Use of Electronic Patient-Reported Outcome (ePRO) Tools Integrated in the Electronic Medical Record During Radiation Therapy for Head and Neck Cancer: Feasibility Study

Purpose Use of electronic patient-reported outcome (ePRO) tools in routine oncology practice can be challenging despite evidence showing they can improve survival, improve patient and practitioner satisfaction, and reduce medical resource utilization. Head and neck cancer (HNC) patients receiving radiation therapy (RT) may be a group that would particularly benefit from interventions focused on early symptom management. Methods Patients undergoing definitive RT for HNC were enrolled in a feasibility study and received ePRO surveys integrated within the electronic medical record (EMR) on a weekly basis during RT. After completion of each ePRO survey, a radiation oncology registered nurse documented the findings and subsequent interventions within the EMR. Results Thirty-four patients with HNC who received curative RT at a single center were enrolled. The total number of surveys completed was 194 with a median of 7 surveys per patient (range 1-8). There was a total of 887 individual abnormal findings reported on the ePROs, and the authors found that all 887 had a corresponding documented intervention. Post-treatment practitioner questionnaires highlighted that ePROs were felt to be helpful for the care team in providing care to HNC patients. Conclusion For patients with HNC receiving RT, ePROs can be effectively utilized to address patient symptoms within an integrated health care system. Creating an infrastructure for the use of ePROs integrated within the EMR in routine care requires an approach that accounts for local workflows and buy-in from patients and the entire care team.

Feasibility study of integrated ePROs in routine care during radiation therapy for head and neck cancer

e13612

Background: Use of electronic Patient Reported Outcomes (ePRO) tools in the routine care of cancer patients remains challenging despite data showing that they can improve resource utilization and patient outcomes. Patients with head and neck cancer during intensive therapy with radiation therapy (RT) may particularly benefit from interventions focused on early symptom management. Methods: 34 patients with head and neck cancer were enrolled in an implementation study and received ePROs integrated within the electronic medical record (EMR) weekly during radiation therapy (RT) within a large integrated health care delivery system. ePROs consisted of the FACT G7 and FACT-HN. After completion of each survey on the patient portal, a radiation oncology RN documented any abnormal findings and subsequent interventions using a standardized format within the EMR. If patients did not have access to the patient portal or had language barriers, they could complete ePROs with a translator by phone or video. Results: Between January and December of 2021, 34 patients with head and neck cancer receiving curative RT were enrolled. The median age 65 years (range 46-84). 74% of patients were male. 59% were white, 26% Asian/PI, 5% Black, and 5% Hispanic. The most common primary cancer sites were: oropharynx (32%), nasopharynx (24%), larynx (18%), oral cavity (9%). 65% of patients received concurrent chemotherapy with RT and 35% received RT alone. 97.4% of patients had access to the online portal. The total number of surveys completed was 194 with a median of 7 per patient (range 1-8). There was a total of 887 abnormal findings reported and 887 documented and corresponding interventions resulting in a 100% intervention rate. Over the course of RT the mean number of abnormal findings increased from 2.26 at baseline (n = 34) to 6.27 at week 7 (n = 24), P < 0.0001. Hospitalizations and Emergency Department (ED) visit data were collected during the study and up to 30 days from last day of RT. There was a total of 2 hospitalizations and 8 ED visits. Conclusions: ePROs integrated within the patient portal and EMR are feasible during RT for patients with head and neck cancer within a large integrated health care system. The use of ePROs integrated within the patient portal and EMR can lead to a high rate of intervention. The increasing number of abnormal findings on ePRO during intensive treatment for head and neck cancer is consistent with known patterns of toxicity and confirm the value of studying methods for improving quality of life in this patient population.[Table: see text]

Investigations on the role of the salmon louse, Lepeophtheirus salmonis (Caligidae), as a vector in the transmission of Aeromonas salmonicida subsp. salmonicida

A bacteria-parasite challenge model was used to study the role of sea lice, Lepeophtheirus salmonis (Copepoda), as a vector of Aeromonas salmonicida subsp. salmonicida. Three hypotheses were tested: (i) L. salmonis can acquire A. salmonicida subsp. salmonicida via water bath exposure; (ii) L. salmonis can acquire the bacteria via parasitizing infected Atlantic salmon, Salmo salar; and (iii) L. salmonis can transmit the bacteria to naïve Atlantic salmon via parasitism. Adult L. salmonis exposed to varying A. salmonicida subsp. salmonicida suspensions (10(1) -10(7)  cells mL(-1) ) for 1.0, 3.0 or 6.0 h acquired the bacteria externally (12.5-100%) and internally (10.0-100%), with higher prevalences associated with the highest concentrations and exposures. After exposure to 10(7)  cells mL(-1) , viable A. salmonicida subsp. salmonicida could be isolated from the external carapace of L. salmonis for 120 h. Lepeophtheirus salmonis also acquired the bacteria externally and internally from parasitizing infected fish. Bacterial transmission was observed only when L. salmonis had acquired the pathogen internally via feeding on 'donor fish' and then by parasitizing smaller (<50 g) 'naive' fish. Under specific experimental conditions, L. salmonis can transfer A. salmonicida subsp. salmonicida via parasitism; however, its role as a mechanical or biological vector was not defined.

Modulation of cellular innate immunity by Lepeophtheirus salmonis secretory products

Lepeophtheirus salmonis produces pharmacologically active substances that have been shown to modify genetic expression of inflammatory mediators in SHK-1 cells and head kidney macrophages of salmon. Differences in genetic expression among genera of Oncorhynchus and Salmo reflect different susceptibilities to L. salmonis. This study was conducted to determine if the presence of L. salmonis secretory products (SEPs)(1) alters the cellular innate immune response (specifically macrophage function) among several salmonids. Phagocytic assays were performed using SHK-1 cells and macrophages isolated from pink (Oncorhynchus gorbuscha), chum (Oncorhynchus keta) and Atlantic (Salmo salar) salmon following incubation with SEPs and Aeromonas salmonicida. Respiratory burst assays were analyzed using pink, chum and Atlantic salmon macrophages after exposure to SEPs. For SHK-1 cells, incubation with SEPS led to dose-dependent increases in phagocytosis. Following incubation with SEPs, chum salmon macrophages had the highest phagocytic index (55.1%) followed by Atlantic (26.4%) and pink (15.8%) salmon. In contrast, respiratory burst response was greatest in pink salmon and minimal in the other two species. Our results suggest that the cellular innate immune response of salmon is modified in the presence of L. salmonis secretions and differences observed among species provide insight into species-specific consequences of sea lice infection.

Rates of transformation of methyl parathion and diethyl phthalate by aufwuchs microorganisms

Using batch cultures, we determined transformation rates for low concentrations of two toxicants-an insecticide, methyl parathion (O,O-dimethyl O-p-nitrophenyl phosphorothioate), and a plasticizer, diethyl phthalate-by aufwuchs, aquatic microbial growth attached to submerged surfaces or suspended in streamers or mats. Aufwuchs samples were collected from field sites, an indoor channel, and a continuous-flow fermentor. Aufwuchs fungi, protozoa, and algae did not transform methyl parathion or diethyl phthalate, but bacteria rapidly transformed both chemicals. Second-order transformation rate coefficients, K(b), based on total plate counts of bacteria in aufwuchs, were determined for potential use in a mathematical model capable of predicting the transport and fate of chemicals in aquatic systems. K(b) for both methyl parathion and diethyl phthalate decreased as the concentration of total bacteria, [B], increased in aufwuchs. This effect resulted from the proportion of nontransformer to transformer bacteria increasing as [B] increased and from the rate of transformation per transformer cell decreasing as [B] increased. First-order transformation rate coefficients, K(1), were relatively stable per unit of surface area colonized by aufwuchs, because K(b) decreased as [B] increased (K(1) = K(b) x [B]).

Initial test of the benchmark chemical approach for predicting microbial transformation rates in aquatic environments

Using 2,4-dichlorophenoxyacetic acid methyl ester (2,4-DME) as a benchmark chemical, we determined relative pseudo-first-order rate coefficients for the butoxyethyl ester of 2,4-dichlorophenoxyacetic acid (2,4-DBE), methyl parathion, and methyl-3-chlorobenzoate in a diversity of microbial samples, including water, sediment, biofilm, and floating microbial mats collected from a laboratory mesocosm as well as from streams, lakes, and wetlands in Georgia and Florida. The decreasing order of reactivity for relative microbial transformation rates was 2,4-DBE > 2,4-DME > methyl-3-chlorobenzoate > methyl parathion. Half-lives of the chemicals varied about 60-fold depending on the chemical and microbial sample. Relative rate coefficients, however, typically varied only about threefold for field-collected samples. Relative rate coefficients determined with samples from a laboratory mesocosm were consistently low compared with the field sample data. Overall, the data indicated that microbial transformation rates of a chemical can be satisfactorily inferred for a wide variety of microbial habitats-such as water, biofilm, or a sediment-on the basis of its transformation rate relative to that of an appropriate benchmark chemical by using a single type of microbial sample.

Kinetics of mixed microbial assemblages enhance removal of highly dilute organic substrates

Our experiments with selected organic substrates reveal that the rate-limiting process governing microbial degradation rates changes with substrate concentration, S, in such a manner that substrate removal is enhanced at lower values of S. This enhancement is the result of the dominance of very efficient systems for substrate removal at low substrate concentrations. The variability of dominant kinetic parameters over a range of S causes the kinetics of complex assemblages to be profoundly dissimilar to those of systems possessing a single set of kinetic parameters; these findings necessitate taking a new approach to predicting substrate removal rates over wide ranges of S.

Non-viral approaches for gene transfer

Gene therapy has great potential to treat or prevent a variety of both genetic and acquired conditions that include neuromuscular disorders, cardiovascular disease, cancer, and infectious diseases. For recessive genetic disorders such as Duchenne muscular dystrophy, delivery of the normal dystrophin gene to muscle should prevent the myofibers from dying. Despite the great promise and sound principles of gene therapy, its application to humans have been hampered by the inability to safely and effectively deliver genes to the target tissues. Among the several gene transfer methods under development, the use of non-viral delivery methods and specifically naked DNA is particularly attractive in that many of the concerns over the use of viral-mediated methods, such as immunogenicity of viral packaging proteins and cost of viral vector production can be avoided. Recently we used limb veins for efficient, repeatable, and safe delivery of nucleic acids to skeletal myofibers throughout the limb muscles of mammals in vivo. Promising results have been obtained in both rodents and larger animals including non-human primates. Studies in the mdx mouse model indicate that the approach should be of use for patients with Duchenne muscular dystrophy. Based upon these encouraging results, a human clinical trial to deliver the human dystrophin gene to patients with DMD is being planned. The initial objective is to preserve hand and forearm function to increase the quality of life.

The beta2-adrenergic receptor specifically sequesters Gs but signals through both Gs and Gi/o in rat sympathetic neurons

Beta(2)-adrenergic receptors (beta(2)-AR) and CB1 cannabinoid receptors share the property of being constitutively active. The CB1 cannabinoid receptor can also sequester G(i/o) proteins; however, it is not known whether the beta(2)-AR can also sequester G proteins. Beta(2)-ARs were heterologously expressed in rat superior cervical ganglion neurons by microinjection of cDNA and studied using the patch-clamp technique. The beta-AR agonist isoproterenol increased the Ca(2+) current 25.9+/-1.6% in neurons microinjected with 100 ng/microl beta(2)-AR cDNA but was without effect on control neurons. Pretreatment with cholera toxin (CTX) abolished the effect of isoproterenol, indicating coupling via G(s) proteins. In neurons microinjected with 200 ng/microl beta(2)-AR cDNA, isoproterenol had the opposite effect of inhibiting the Ca(2+) current 36.5+/-2.0%. Inhibition of the Ca(2+) current was sensitive to pertussis toxin, indicating beta(2)-AR coupling to G(i/o) proteins. Pretreatment with CTX resulted in a greater 54+/-3.8% inhibition of the Ca(2+) current, indicating that G(s) coupling masks the full effect of G(i/o) coupling. Expression of beta(2)-ARs abolished signaling by G(s)-coupled receptors for vasoactive intestinal polypeptide (VIP). VIP inhibited the Ca(2+) current 49.5+/-0.5% in control neurons but had no effect in neurons expressing beta(2)-ARs. In contrast, expression of beta(2)-ARs had no effect on signaling by the G(i/o)-coupled alpha(2)-adrenergic receptor. This study demonstrates that the beta(2)-AR couples to both G(s) and G(i/o) proteins but specifically sequesters G(s) proteins, preventing their interaction with another G(s)-coupled receptor. beta(2)-adrenergic receptors thus have the potential to prevent other G(s)-coupled receptors from transducing their biological signals.

The proximal and distal C-terminal tail domains of the CB1 cannabinoid receptor mediate G protein coupling

The human CB1 cannabinoid receptor couples to G(i/o) proteins and inhibits neuronal voltage-gated Ca2+ channels. The role of the C-terminal tail of the CB1 cannabinoid receptor in G(i/o) protein coupling was examined using the superior cervical ganglion neuronal expression system. Deletion of the distal intracellular C-terminal tail (amino acids 418-472) slowed the kinetics and reduced the magnitude of Ca2+ channel inhibition. Deletion of the entire intracellular C-terminal tail (amino acids 401-472) abolished Ca2+ channel inhibition demonstrating the critical role of the proximal amino acids 401-417 of the C-terminal tail in G protein signaling. Expression of the C-terminal truncated receptors on the cell surface was examined using an N-terminal CB1 antibody. Both the C-terminal truncated receptors were expressed on the cell surface and were no different from wild type CB1 cannabinoid receptors. This study establishes that the proximal CB1 cannabinoid receptor intracellular C-terminal tail domain (amino acids 401-417) is critical for G(i/o) protein coupling and that the distal C-terminal tail domain (amino acids 418-472) profoundly modulates both the magnitude and kinetics of signal transduction. Thus, the C-terminal tail of the CB1 cannabinoid receptor has a wider role in G protein coupling than was previously thought.

Interactions of the Tribolium Sex combs reduced and proboscipedia orthologs in embryonic labial development

The role of Hox genes in the development of insect gnathal appendages has been examined in three insects: the fruitfly, Drosophila melanogaster; the milkweed bug, Oncopeltus fasciatus; and the red flour beetle, Tribolium castaneum. In each of these organisms, the identity of the labium depends on the homeotic genes Sex combs reduced (Scr) and proboscipedia (pb). Loss of pb function in each of the three insects results in homeotic transformation of the labial appendages to legs. In contrast, loss of Scr function yields a different transformation in each species. Interestingly, mutations in Cephalothorax (Cx), the Tribolium ortholog of Scr, transform the labial appendages to antennae, a result seen in the other insects only when both pb and Scr are removed. We show here that the Tribolium labial appendages also develop as antennae in double mutants. Further, we demonstrate that expression of the Tribolium proboscipedia ortholog maxillopedia (mxp) is greatly reduced or absent in the labium of Cx mutant larvae. Thus, in the wild-type labial segment, Cx function is required (directly or indirectly) for mxp transcription. A similar interaction between Scr and pb during Drosophila embryogenesis has been described recently. Thus, this regulatory paradigm appears to be conserved at least within the Holometabola.

Structural domains of the CB1 cannabinoid receptor that contribute to constitutive activity and G-protein sequestration

The CB1 cannabinoid receptor is a constitutively active receptor that can sequester G(i/o)-proteins and prevent other G(i/o)-coupled receptors from signaling (Bouaboula et al., 1997; Pan et al., 1998; Vasquez and Lewis, 1999). G-protein sequestration occurs because the population of CB1 cannabinoid receptors exists in both an inactive G-protein-precoupled RG(GDP) state and a constitutively active R*G(GTP) state. We tested the hypothesis that the distal C-terminal tail acts to prevent G-protein activation. We found that truncation of the distal C-terminal tail of the CB1 receptor (CB1-417) enhanced both the constitutive activity and the ability of the receptor to sequester G-proteins. In addition, we tested the hypothesis that the conserved aspartate (D2.50) in the second transmembrane domain of the CB1 cannabinoid receptor is crucial for constitutive activity and G-protein sequestration. We found that the mutation of aspartate to asparagine (CB1-D164N) abolished G-protein sequestration and constitutive receptor activity without disrupting agonist-stimulated activity. We conclude that the CB1-D164N mutation and the C-terminal truncation shift the population of receptors in opposite directions. The CB1-D164N mutation shifts the receptor into an inactive R state upcoupled from G-proteins, whereas the C-terminal truncation (CB1-417) shifts the receptor into the active R*G(GTP) state. Thus the distal C-terminal tail acts to constrain the receptor from activating G-proteins, whereas the aspartate (D2.50) in the second transmembrane domain stabilizes the receptor in both the inactive RG(GDP) state and the active R*G(GTP) state.

Distinct roles of the homeotic genes Ubx and abd-A in beetle embryonic abdominal appendage development

Insects are easily distinguishable by the absence of legs on the adult abdomen. Studies performed on the Dipteran, Drosophila melanogaster, indicate that this is because of the repressive effects of the homeotic genes Ultrabithorax (Ubx) and abdominal-A (abd-A) on the limb promoting gene Distal-less (Dll) during embryonic development. However, in many species appendage-like structures are present on abdominal segments in embryonic and juvenile stages. Here, by using classical genetics and double-stranded RNA-mediated gene silencing in the red flour beetle, Tribolium castaneum, a species that develops an appendage on the first abdominal segment, we investigate the roles of Ubx and Abd-A in abdominal limb development. We find that in Tribolium, Abd-A, but not Ubx, represses early expression of Dll in the embryonic abdomen. Ubx appears to modify the A1 appendage. This difference in the activities of Abd-A and Ubx is critical for proper development of this appendage. We suggest that an ancestral role of Abd-A in insect abdominal appendage development was in the repression of Dll initiation and that of Ubx was in modulation of abdominal appendage morphology.

Ectopic gene expression and homeotic transformations in arthropods using recombinant Sindbis viruses

BACKGROUND

The morphological diversity of arthropods makes them attractive subjects for studying the evolution of developmental mechanisms. Comparative analyses suggest that arthropod diversity has arisen largely as a result of changes in expression patterns of genes that control development. Direct analysis of how a particular gene functions in a given species during development is hindered by the lack of broadly applicable techniques for manipulating gene expression.

RESULTS

We report that the Arbovirus Sindbis can be used to deliver high levels of gene expression in vivo in a number of non-host arthropod species without causing cytopathic effects in infected cells or impairing development. Using recombinant Sindbis virus, we investigated the function of the homeotic gene Ultrabithorax in the development of butterfly wings and beetle embryos. Ectopic Ultrabithorax expression in butterfly forewing imaginal discs was sufficient to cause the transformation of characteristic forewing properties in the adult, including scale morphology and pigmentation, to those of the hindwing. Expression of Ultrabithorax in beetle embryos outside of its endogenous expression domain affected normal development of the body wall cuticle and appendages.

CONCLUSIONS

The homeotic genes have long been thought to play an important role in the diversification of arthropod appendages. Using recombinant Sindbis virus, we were able to investigate homeotic gene function in non-model arthropod species. We found that Ultrabithorax is sufficient to confer hindwing identity in butterflies and alter normal development of anterior structures in beetles. Recombinant Sindbis virus has broad potential as a tool for analyzing how the function of developmental genes has changed during the diversification of arthropods.

The CB1 cannabinoid receptor can sequester G-proteins, making them unavailable to couple to other receptors

We tested the hypothesis that human CB1 cannabinoid receptors (hCB1) can sequester G(i/o)-proteins from a common pool and prevent other receptors from signaling. Human CB1 cannabinoid receptors were expressed in superior cervical ganglion (SCG) neurons by microinjection of hCB1 cDNA. Expression of hCB1 cannabinoid receptors abolished the Ca(2+) current inhibition by endogenous pertussis toxin-sensitive G(i/o)-coupled receptors for norepinephrine (NE) and somatostatin (SOM) but not by endogenous pertussis toxin-insensitive G(s)-coupled receptors for vasoactive intestinal polypeptide. Signaling by NE was rescued by expression of Galpha(oB), Gbeta(1), and Ggamma(3). Expression of mGluR2 metabotropic glutamate receptors, another pertussis toxin-sensitive G-protein-coupled receptor, had no effect on the signaling by NE or SOM. Some hCB1 receptors were constitutively active because the cannabinoid receptor inverse agonist SR 141617A enhanced the Ca(2+) current. Some hCB1 receptors also appear to be precoupled to G(i/o)-proteins because the cannabinoid agonist WIN 55,212-2 decreased the Ca(2+) current at a time when no G-proteins were available to couple to alpha(2)-adrenergic and somatostatin receptors. In SCG neurons microinjected with a lower concentration of hCB1 cDNA, the effect of SR 141716A was reduced, and the response to NE and SOM was partially restored. Subsequent to the application of SR 141716A, the Ca(2+) current inhibition by NE and SOM was abolished. These results suggest that both the active and inactive states of the hCB1 receptor can sequester G(i/o)-proteins from a common pool. Cannabinoid receptors thus have the potential to prevent other G(i/o)-coupled receptors from transducing their biological signals.

Influence of environmental changes on degradation of chiral pollutants in soils

Numerous anthropogenic chemicals of environmental concern--including some phenoxy acid herbicides, organophosphorus insecticides, polychlorinated biphenyls, phthalates, freon substitutes and some DDT derivatives--are chiral. Their potential biological effects, such as toxicity, mutagenicity, carcinogenicity, and endocrine disrupter activity, are generally enantiomer-selective, and different enantiomers are preferentially degraded (transformed) by micro-organisms in various environments. Here we use field and laboratory experiments to demonstrate that environmental changes in soils can alter these preferences, and to suggest that the preferences shift owing to different groups of related microbial genotypes being activated by different environmental changes. In Brazilian soils, almost all pasture samples preferentially transformed the non-herbicidal enantiomer of dichlorprop ((RS)-2-(2,4-dichlorophenoxy)propionic acid), while most forest samples either transformed the herbicidal enantiomer more readily or as rapidly as the non-herbicidal enantiomer. Organic nutrient enrichments shifted enantioselectivity for methyl dichlorprop ((RS)-methyl 2-(2,4-dichlorophenoxy)propionic acid) strongly towards preferentially removing the non-herbicidal enantiomer in soils from Brazil and North America, potentially increasing phytotoxicity of its residues relative to that of the racemate. Assessments of the risks chemical pollutants pose to public health and the environment need to take into account the chiral selectivity of microbial transformation processes and their alteration by environmental changes, especially for pesticides as up to 25 per cent are chiral.

Recruitment of a hedgehog regulatory circuit in butterfly eyespot evolution

The origin of new morphological characters is a long-standing problem in evolutionary biology. Novelties arise through changes in development, but the nature of these changes is largely unknown. In butterflies, eyespots have evolved as new pattern elements that develop from special organizers called foci. Formation of these foci is associated with novel expression patterns of the Hedgehog signaling protein, its receptor Patched, the transcription factor Cubitus interruptus, and the engrailed target gene that break the conserved compartmental restrictions on this regulatory circuit in insect wings. Redeployment of preexisting regulatory circuits may be a general mechanism underlying the evolution of novelties.

SR 141716A acts as an inverse agonist to increase neuronal voltage-dependent Ca2+ currents by reversal of tonic CB1 cannabinoid receptor activity

The CB1 cannabinoid receptor antagonist SR 141716A abolished the inhibition of Ca2+ currents by the agonist WIN 55,212-2. However, SR 141716A alone increased Ca2+ currents, with an EC50 of 32 nM, in neurons that had been microinjected with CB1 cRNA. For an antagonist to elicit an effect, some receptors must be tonically active. Evidence for tonically active CB1 receptors was seen as enhanced tonic inhibition of Ca2+ currents. Preincubation with anandamide failed to enhance the effect of SR 141716A, indicating that anandamide did not cause receptor activity. Under Ca2+-free conditions designed to block the Ca2+-dependent formation of anandamide and sn-2-arachidonylglycerol, SR 141716A again increased the Ca2+ current. The Ca2+ current was tonically inhibited in neurons expressing the mutant K192A receptor, which has no affinity for anandamide, demonstrating that this receptor is also tonically active. SR 141716A had no effect on the Ca2+ current in these neurons, but SR 141716A could still antagonize the effect of WIN 55, 212-2. Thus, the K192 site is critical for the inverse agonist activity of SR 141716A. SR 141716A appeared to become a neutral antagonist at the K192A mutant receptor. Native cannabinoid receptors were studied in male rat major pelvic ganglion neurons, where it was found that WIN 55,212-2 inhibited and SR 141716A increased Ca2+ currents. Taken together, our results demonstrate that a population of native and cloned CB1 cannabinoid receptors can exist in a tonically active state that can be reversed by SR 141716A, which acts as an inverse agonist.

Expression pattern of a butterfly achaete-scute homolog reveals the homology of butterfly wing scales and insect sensory bristles

BACKGROUND

Lepidopteran wing scales are the individual units of wing color patterns and were a key innovation during Lepidopteran evolution. On the basis of developmental and morphological evidence, it has been proposed that the sensory bristles of the insect peripheral nervous system and the wing scales of Lepidoptera are homologous structures. In order to determine if the developmental pathways leading to Drosophila sensory bristle and butterfly scale formation use similar genetic circuitry, we cloned, from the butterfly Precis coenia, a homolog of the Drosophila achaete-scute (AS-C) genes--which encode transcription factors that promote neural precursor formation--and examined its expression pattern during development.

RESULTS

During embryonic and larval development, the expression pattern of the AS-C homolog, ASH1, forecasted neural precursor formation. ASH1 was expressed both in embryonic proneural clusters--within which an individual cell retained ASH1 expression, enlarged, segregated, and became a neural precursor--and in larval wing discs in putative sensory mother cells. ASH1 was also expressed in pupal wings, however, in evenly spaced rows of enlarged cells that had segregated from the underlying epidermis but, rather than give rise to neural structures, each cell contributed to an individual scale.

CONCLUSIONS

ASH1 appears to perform multiple functions throughout butterfly development, apparently promoting the initial events of selection and formation of both neural and scale precursor cells. The similarity in the cellular and molecular processes of scale and neural precursor formation suggests that the spatial regulation of an AS-C gene was modified during Lepidopteran evolution to promote scale cell formation.

A comparison of threshold-based fitting strategies for nonlinear hearing aids

OBJECTIVE

In recent years, wide dynamic range compression (WDRC) has been used with increasing success. To optimize the fit with this type of hearing aid circuitry, subjective measures of loudness growth often are used. Unfortunately, these type of measures cannot be performed with infants, young children, and some elderly individuals. The primary purpose of this study was to compare the fitting recommendations of two recently described threshold-based procedures for fitting nonlinear hearing aids (DSL 4.0 and FIG6) to the use gain settings of satisfied adult hearing aid users for whom the fitting was based on subjective measures of loudness growth. Because it cannot be assumed that the use settings for adults will be appropriate for young children, a secondary goal was to quantify the audibility of speech at the use settings derived from loudness growth measures.

DESIGN

Forty-nine adult hearing aid users with mild to severe sensorineural hearing loss participated in this study. For all subjects, loudness growth measures were used to optimize the fit of a 2-channel WDRC hearing aid. The use gain at 50 and 80 dB SPL was compared with the gain recommended by DSL, FIG6, and the manufacturer's threshold-based fitting algorithm.

RESULTS

In general, both DSL and FIG6 prescribed more gain than actually was used by these hearing aid wearers. These discrepancies increased as a function of frequency, and differences in excess of 20 dB were observed in some cases. The manufacturer's algorithm provided a closer approximation to the use gain than either DSL or FIG6. Utilizing these use gain values, an Aided Audibility Index (AAI) was calculated for soft, average, and loud speech across four degrees of hearing loss, ranging from mild to severe (12 conditions). Transfer functions for continuous discourse and nonsense syllables were applied to yield estimated intelligibility scores. For the higher context speech materials, estimated intelligibility was > or = 85% for nine of the 12 conditions. For low-context speech materials, estimated intelligibility was > or = 85% for only three of the 12 conditions.

CONCLUSIONS

Results suggest that the gain recommendations provided by both DSL and FIG6 exceeded the gain actually used by the adult hearing-impaired subjects in this study. Gain recommendations from the manufacturer's algorithm provided a closer approximation to the use gain values of these subjects. These findings suggest that, for adult hearing aid users who cannot perform loudness judgments reliably, the manufacturer's algorithm would be expected to provide a closer approximation to loudness-based use gain values than either DSL or FIG6. However, AAI calculations revealed that the gain recommendations from this algorithm produce adequate audibility of speech only if one assumes linguistic competence. When AAI values are transformed to predict the intelligibility of low-context speech materials, it appears that the degree of audibility may not be appropriate for prelingually hearing-impaired children with more than a moderate hearing loss.

The prevalence of chapped lips during an army hot weather exercise

OBJECTIVES

To identify risk factors associated with chapped lips in soldiers during prolonged exposure to a hot, dry environment.

METHODS

We examined 1,053 of 2,500 soldiers (42%) participating in a desert training exercise at Fort Irwin, California, in September 1983. We measured the prevalence of chapped lips during the third week of a 4-week training period. Our independent variables (complexion, sex, lip protectant use, age, and the prevalence of recurrent herpes labialis) were obtained by observation and interview.

RESULTS

We found severe chapping in 150 (10%) and moderate chapping in 247 (23.5%) of the soldiers. Stepwise ordinal logistic regression was used to identify risk factors associated with chapped lips and to determine the prevalence odds ratios (OR). Risk factors with statistically significant associations with chapped lips were the presence of recurrent herpes labialis (OR = 2.88), very fair complexion (OR = 3.23), and fair complexion (OR = 1.58).

CONCLUSIONS

Moderate to severe chapping occurred in approximately one-third of the soldiers. Lip protectants appeared to be relatively ineffective in the prevention and treatment of chapped lips but were associated with a lower prevalence of recurrent herpes labialis.

The effects of gamma-oryzanol supplementation during resistance exercise training

To determine the effectiveness of gamma-oryzanol supplementation, weight-trained males were randomly divided into supplemented (G-O) and control placebo (Con) groups. The G-O group ingested 500 mg.day-1 of gamma-oryzanol according to manufacturer's instructions. Test batteries were administered before (T1), after 4 weeks (T2), and after 9 weeks (T3) of a periodized resistance exercise program. Both groups demonstrated significant increases in 1 repetition maximum muscular strength (bench press and squat) and vertical jump power, with no differences between the groups. No differences between groups were observed for measures of circulating concentrations of hormones (testosterone, cortisol, estradiol, growth hormone, insulin, beta-endorphin), minerals (calcium, magnesium), binding protein (albumin), or blood lipids (total cholesterol, triglycerides, HDL-cholesterol). Resting cardiovascular variables decreased similarly for both groups. These data suggest that 9 weeks of 500 mg.day-1 of gamma-oryzanol supplementation does not influence performance or related physiological parameters in moderately weight-trained males.

Inhibition of M-type K+ and N-type Ca2+ channels by the human gonadotropin-releasing-hormone receptor heterologously expressed in adult neurons

Gonadotropin-releasing hormone (GnRH) controls all aspects of reproductive function. GnRH is secreted by hypothalamic neurons and exerts its effects on the endocrine system through pituitary gonadotropes, while its effects on sexual receptivity are mediated by the central nervous system. The electrophysiological responses of central neurons to GnRH have shown both excitatory and inhibitory responses, but little is known about the mechanisms by which GnRH can change neuronal excitability. The present study addresses the mechanisms whereby stimulation of the human GnRH receptor changes neuronal excitability by using a combination of electrophysiological and heterologous expression techniques. Microinjection of in vitro transcribed cRNA coding for the human GnRH receptor into enzymatically dissociated adult rat superior cervical ganglion neurons resulted in GnRH receptor expression. Activation of the GnRH receptor inhibited both M-type K+ and N-type Ca2+ channels. Inhibition of M-type K+ channels was insensitive to pertussis toxin pretreatment and blocked by intracellular GDPbetaS. Inhibition of Ca2+ channels was slow in onset, voltage independent and insensitive to pertussis toxin. Wash-out of GnRH resulted in an unusual transient reversal of tonic G-protein-mediated Ca2+ channel inhibition. Block of the N-type Ca2+ channel with omega-conotoxin GVIA decreased Ca2+ current inhibition from 43 to 15%, indicating that the N-type Ca2+ channel is an effector target. Ca2+ channel inhibition was completely abolished by including a Ca2+ chelator in the patch pipette. Cell-attached macropatch experiments indicated that Ca2+ channel inhibition is mediated by a diffusible second messenger. These results demonstrate that the human GnRH receptor can inhibit M-type K+ and N-type Ca2+ channels when heterologously expressed in adult rat neurons. Modulation of M-type K+ and N-type Ca2+ channels in central neurons which contain GnRH receptors is likely to contribute to the changes in neuronal excitability elicited by GnRH.

Neuropeptide Y and calcitonin gene-related peptide modulate voltage-gated Ca2+ channels in mature female rat paracervical ganglion neurons

OBJECTIVE

To assess the predominant subtype of calcium channel present in neurons of the paracervical ganglia (PG) of the female rat and the ability of neuroactive peptide to modulate total calcium current.

METHODS

Whole-cell patch clamp techniques were used on isolated PG neurons to assess calcium current modulation in the presence and absence of selective calcium channel subtype inhibitors and neuropeptides. Digital imaging analysis of cells was used to determine neuronal cell size distributions within the ganglia.

RESULTS

Average PG cell diameter was 28.1 microns. Most PG neurons (64%) had an N-type calcium current that contributed 41% of the total calcium current. The low voltage-activated or T-type current was not present. Very few neurons (22%) were sensitive to the P-type calcium channel blocker omega-agatoxin IVA, and in only 10% of neurons was the calcium current sensitive to the L-type channel blocker nimodipine. Neuropeptide Y (NPY) inhibited the calcium current by 41% in 79% of the neurons, but vasoactive intestinal peptide (VIP) had no effect. Calcitonin gene-related peptide (CGRP) both increased and decreased the calcium current in separate cell populations.

CONCLUSIONS

Calcium currents in female rat PG neurons are carried primarily through N-type calcium channels with a small contribution from L- and P-type channels. An unidentified calcium channel type is also present. Modulation of the calcium current by NPY is demonstrated, and support for the presence of a local, CGRP-mediated circuit is presented.

Catalytic subunit of mitochondrial DNA polymerase from Drosophila embryos. Cloning, bacterial overexpression, and biochemical characterization

A full-length cDNA of the catalytic subunit of mitochondrial DNA polymerase from Drosophila embryos has been obtained, and its nucleotide sequence was determined. The cDNA clone encodes a polypeptide with a deduced amino acid sequence of 1145 residues and a predicted molecular mass of 129.9 kDa. Amino-terminal sequence analysis of the mature catalytic subunit of the heterodimeric mitochondrial enzyme from Drosophila embryos identified the amino-terminal amino acid at position +10 in the deduced amino acid sequence, indicating a mitochondrial presequence peptide of only nine amino acids. Alignment of the catalytic subunit sequence with that of Escherichia coli DNA polymerase I Klenow fragment indicated a high degree of amino acid sequence conservation in each of the three DNA polymerase and three 3' --> 5' exonuclease domains identified by biochemical studies in the latter enzyme. Bacterial overexpression, purification, and biochemical analysis demonstrated both 5' --> 3' DNA polymerase and 3' --> 5' exonuclease in the recombinant polypeptide. This represents the first demonstration of 3' --> 5' exonuclease activity in the polymerase catalytic subunit of animal mitochondrial DNA polymerase.

Rat brain cannabinoid receptor modulates N-type Ca2+ channels in a neuronal expression system

Modulation of neuronal ion channels by the cloned rat brain CB1 cannabinoid receptor was investigated with the use of a heterologous neuronal expression system. Transient expression of the rat brain CB1 cannabinoid receptor was accomplished through microinjection of in vitro transcribed cRNA into the cytoplasm of enzymatically dissociated adult rat superior cervical ganglion neurons. The cannabimimetic aminoalkylindole WIN 55,212-2 inhibited whole-cell Ca2+ currents in neurons injected 16-25 hr previously with rat brain CB1 cannabinoid receptor cRNA. Inhibition of the Ca2+ current was voltage and concentration dependent, with a maximal inhibition of 73% and an IC50 value of 47 nM. The synthetic cannabinoid analogue CP55,940 also inhibited Ca2+ currents, with a maximal inhibition of 38% and an IC50 value of 7 nM. Ca2+ current inhibition was blocked by inclusion of guanosine-5'-O-(2-thiodiphosphate) in the intracellular patch pipette solution or by pretreatment with pertussis toxin. Pretreatment with the N-type Ca2+ channel antagonist omega-conotoxin GVIA reduced the inhibition by 100 nM WIN 55,212-2 from 44% to 6%, indicating that N-type Ca2+ channels are a target of cannabinoid action. On washout of WIN 55,212-2, the Ca2+ current amplitude "overrecovered" in 47% of the neurons tested. Anandamide, the endogenous cannabimimetic compound, had an inconsistent effect on the voltage-dependent Ca2+ currents in the majority of neurons microinjected with cannabinoid receptor cRNA. Ca2+ channels were a specific effector target of the cannabinoid receptor, as two different K+ currents, the M current and the A current, were not modulated by the cannabimimetic WIN 55,212-2.

L- and N-type Ca2+ channels in adult rat carotid body chemoreceptor type I cells

1. Whole-cell voltage-dependent Ca2+ currents recorded from chemoreceptor type I cells of the adult rat carotid body had maximum amplitudes of -94 pA in 10 mM Ca2+ and were half-inactivated at a holding potential of -38 mV. Somatostatin and dopamine inhibited whole-cell Ca2+ current in type I cells. 2. The dihydropyridine agonist (+)202-791 increased the Ca2+ current amplitude by 106% at a step potential of -18 mV. The dihydropyridine antagonist nimodipine decreased the Ca2+ current amplitude by 40% from a holding potential of -80 mV, and by 74% from a holding potential of -60 mV. The nimodipine-sensitive current had a maximum amplitude at a membrane potential of -12 mV. omega-Conotoxin GVIA (omega-CgTX GVIA) blocked the whole-cell Ca2+ current by 40%. The omega-CgTX GVIA-sensitive current had a maximum amplitude at a membrane potential of +2 mV. 3. In summary, type I cells of the adult rat carotid body have dihydropyridine-sensitive L-type and omega-conotoxin GVIA-sensitive N-type voltage-dependent Ca2+ channels. These channels may play a role in the voltage-gated entry of Ca2+ necessary for stimulus-secretion coupling in response to changes in arterial PO2, PCO2 and pH. Inhibition of the Ca2+ currents by somatostatin and dopamine may alter the chemotransduction signal in type I cells.

Drosophila melanogaster mitochondrial DNA: completion of the nucleotide sequence and evolutionary comparisons

The nucleotide sequence of the regions flanking the A+T region of Drosophila melanogaster mitochondrial DNA (mtDNA) has been determined. Included are the genes encoding the transfer RNAs for valine, isoleucine, glutamine and methionine, the small ribosomal RNA and the 5'-coding sequences of the large ribosomal RNA and NADH dehydrogenase subunit II. This completes the nucleotide sequence of the D. melanogaster mitochondrial genome. The circular mtDNA of D. melanogaster varies in size among different populations largely due to length differences in the control region (Fauron & Wolstenholme, 1976; Fauron & Wolstenholme, 1980a, b); the mtDNA region we have sequenced, combined with those sequenced by others, yields a composite genome that is 19,517 bp in length as compared to 16,019 bp for the mtDNA of D. yakuba. D. melanogaster mtDNA exhibits an extreme bias in base composition; it comprises 82.2% deoxyadenylate and thymidylate residues as compared to 78.6% in D. yakuba mtDNA. All genes encoded in the mtDNA of both species are in identical locations and orientations. Nucleotide substitution analysis reveals that tRNA and rRNA genes evolve at less than half the rate of protein coding genes.

Resistance of microorganisms to disinfection in dental and medical devices

The U.S. Centers for Disease Control and Prevention (CDC) recommends that only heat sterilization be used for all reusable devices entering the oral cavity. However, chemical disinfection is still employed for reprocessing dental devices in many areas of the world. In an analysis of a Florida dental practice responsible for nosocomial human immunodeficiency virus (HIV) transmissions, the possible role of contaminated devices was deemed unlikely in part because they were subjected to high-level disinfection with 2% glutaraldehyde. Disease transmissions have, however, been documented for endoscopes used in diagnostic and surgical procedures even after this treatment. In some dental devices, lubricants mix with potentially infectious patient materials, and organic debris has been observed in endoscopes after cleaning. We have investigated whether lubricants can render high-level chemical disinfection procedures ineffective and have addressed the role that some common devices may play in disease transmission. We report here that HIV in whole-blood samples and Pseudomonas aeruginosa in blood and plasma survived high-level disinfection when entrapped in lubricants used in dental handpieces and endoscopes. We also found that lubricated dental devices used to clean and polish teeth (prophylaxis angles) have the potential to transfer sufficient amounts of blood to infect human lymphocyte cultures with HIV. These results emphasize the need to subject reusable dental devices to a heat-sterilization protocol that penetrates the lubricant.

Heterologous expression of metabotropic glutamate receptors in adult rat sympathetic neurons: subtype-specific coupling to ion channels

A novel heterologous expression system was used to examine the coupling of metabotropic glutamate receptors (mGluRs) to neuronal voltage-gated ion channels. Cytoplasmic injection of mGluR2 cRNA into adult rat sympathetic neurons resulted in the expression of receptors that negatively coupled to N-type Ca2+ channels through a pertussis toxin-sensitive pathway. Injection of mGluR1 alpha cRNA resulted in the expression of receptors that inhibited M-type K+ channels via a pertussis toxin-insensitive pathway. Coupling was restricted to specific transduction elements and effectors, since mGluR2 did not inhibit M channels and mGluR1 alpha had minimal effects on Ca2+ channels. These findings demonstrate that heterologously expressed, and thus unambiguously identified, mGluR subtypes modulate specific neuronal ion channels through discrete signal transduction pathways.

Sequence, organization, and evolution of the A+T region of Drosophila melanogaster mitochondrial DNA

The long (4.6-kb) A+T region of Drosophila melanogaster mitochondrial DNA has been cloned and sequenced. The A+T region is organized in two large arrays of tandemly repeated DNA sequence elements, with nonrepetitive intervening and flanking sequences comprising only 22% of its length. The first repeat array consists of five repeats of 338-373 bp. The second consists of four intact 464-bp repeats and a fifth partial repeat of 137 bp. Three DNA sequence elements are found to be highly conserved in D. melanogaster and in several Drosophila species with short A+T regions. These include a 300-bp DNA sequence element that overlaps the DNA replication origin and two thymidylate stretches identified on opposite DNA strands. We conclude that the length heterogeneity observed in the A+T regulatory region in mitochondrial DNAs from the genus Drosophila results from the expansion (and contraction) of the number of repeated DNA sequence elements. We also propose that the 300-bp conserved DNA sequence element, in conjunction with another primary sequence determinant, perhaps the adjacent thymidylate stretch, functions in the regulation of mitochondrial DNA replication.

Enhanced expression of Ca2+ channels by nerve growth factor and the v-src oncogene in rat phaeochromocytoma cells

1. Rat phaeochromocytoma (PC12) cells were used to investigate the expression of Ca2+ channel types during neuronal differentiation. Neuronal differentiation was induced by treatment with nerve growth factor (NGF) or by activation of a temperature-sensitive tyrosine kinase (pp60v-src) in genetically modified PC12 (PC12/v-src) cells. PC12 cells differentiated morphologically in the presence of NGF. When grown at the permissive temperature of 37 degrees C which activates the kinase activity of pp60v-src, PC12/v-src cells differentiated morphologically with the extension of neurites. In contrast, PC12/v-src cells grown at the non-permissive temperature of 40 degrees C continued to divide and were morphologically indistinguishable from control PC12 cells. 2. Whole-cell Ca2+ currents were measured in PC12 cells using Ba2+ as the charge carrier. Ba2+ currents measured at the peak of the current-voltage curve from a holding potential of -80 mV were -0.28 +/- 0.04 nA (mean +/- S.E.M.) in control PC12 cells compared to -1.25 +/- 0.16 nA in NGF-differentiated cells. The current density increased from 9.4 +/- 0.7 pA/pF in control PC12 cells to 22.8 +/- 2.4 pA/pF in NGF-differentiated PC12 cells. Ba2+ currents were -0.24 +/- 0.04 nA in undifferentiated PC12/v-src cells grown at the non-permissive temperature of 40 degrees C compared to -0.95 +/- 0.16 nA in differentiated PC12/v-src cells grown at the permissive temperature of 37 degrees C. The current density increased from 4.5 +/- 0.5 pA/pF in PC12/v-src cells grown at the non-permissive temperature of 40 degrees C to 13.3 +/- 2.4 pA/pF in PC12/v-src cells grown at the permissive temperature of 37 degrees C. 3. The sensitivity of Ba2+ currents to omega-conotoxin GVIA (omega-CgTX) was determined for currents measured at the peak of the current-voltage curve (0 mV in 10 mM Ba2+) from a holding potential of -80 mV. In NGF-differentiated PC12 cells, 10 microM omega-CgTx inhibited 68.1 +/- 3.2% of the total Ba2+ current compared to 35.9 +/- 4.1% in control cells. The density of the omega-CgTX-sensitive current increased from 3.3 +/- 0.4 pA/pF in control cells to 15.7 +/- 2.0 pA/pF in NGF-differentiated cells. In differentiated PC12/v-src cells grown at 37 degrees C, omega-CgTX inhibited 52.2 +/- 4.2% of total Ba2+ current compared to 41.1 +/- 3.8% in PC12/v-src cells grown at 40 degrees C. The density of the omega-CgTX-sensitive current increased from 1.9 +/- 0.3 to 7.4 +/- 2.0 pA/pF with v-src-mediated differentiation.(ABSTRACT TRUNCATED AT 400 WORDS)

Cross-contamination potential with dental equipment

Some types of reused dental equipment, especially handpieces and their attachments for drilling and cleaning teeth, might be responsible for cross-contamination if patient material were to lodge temporarily in difficult-to-disinfect internal mechanisms. This possibility is worrisome with respect to transmission of hepatitis B and human immunodeficiency viruses (HBV, HIV). Previous cross-contamination studies have relied on laboratory experiments with bacteria or dye tracers. To assess possible risk more thoroughly, we tested 30 new prophylaxis angles and 12 new high-speed handpieces to see whether they would take up and expel contaminants in laboratory and clinical trials. In treatments of three patients, including two infected with HIV, human-specific DNA (beta-globin, HLA DQ alpha) and HIV proviral DNA were detected inside or coming back from the devices. Similarly, when handpieces were operated in contact with blood pooled from HBV-infected patients, HBV DNA was detected in samples taken from inside the equipment and from their attached air/water hoses. When we used bacteriophage phi X174 as a model virus in laboratory tests, many infective viral particles were recovered from internal mechanisms of handpieces, their connecting air/water hoses, and from water spray expelled when the equipment was reused. We recommend that reused high-speed, air-driven handpieces and prophylaxis angles should be cleaned and heat-treated between patients. Further studies are needed to determine ways of eliminating the risks associated with exhaust hoses and air/water input lines.

Heterologous expression of the human potassium channel Kv2.1 in clonal mammalian cells by direct cytoplasmic microinjection of cRNA

The cloned human delayed rectifying K+ channel Kv2.1 (drk1) was expressed in clonal mouse fibroblasts (L-cells) and rat basophilic leukemia cells (RBL-1) by direct cytoplasmic microinjection of complementary RNA (cRNA). Within six hours, cells microinjected with Kv2.1 cRNA expressed a large sustained outward current as determined from whole-cell patch-clamp recordings. Nearly 100% of cells injected with cRNA expressed outward current. Current density was 30-70 pA/pF when measured at a potential of +50 mV. Steady-state activation and inactivation parameters for Kv2.1 were similar when expressed in either L-cells or RBL-1 cells. These results are the first to demonstrate that functional ion channel proteins can be expressed in mammalian clonal cell lines by direct cytoplasmic microinjection of cRNA.

The prevalence of recurrent herpes labialis during an army hot weather exercise

A survey was performed on 1,062 of 2,500 (42%) Army personnel participating in a desert training exercise at Fort Irwin, California, in September 1983. The prevalence of recurrent herpes labialis (RHL) and chapped lips was observed during the third week of a four-week training period. Complexion, sex, lip protectant use, age, and time spent outdoors were obtained by observation and interview. Recurrent herpes labialis was found in 46 subjects (4%). Stratified analysis and stepwise logistic regression were used to identify risk factors associated with RHL and to determine the prevalence odds ratios (POR). Risk factors with statistically significant associations with RHL were lip protectant use (POR = 0.19), chapped lips (POR = 2.87), being female (POR = 5.00), and light complexion (POR = 2.48). These findings strongly support the use of lip protectants during prolonged exposure to hot, dry climates as a prophylaxis against recurrent herpes labialis. Additional studies should focus on excitatory factors of RHL; and clinical trials of the efficacy of the lip protectants to protect against RHL and chapped lips should be undertaken.

Cross-infection risks associated with current procedures for using high-speed dental handpieces

When a dye solution used to simulate patient material was either injected into high-speed dental handpiece (drill) waterlines or applied to the equipment externally, internal air turbine chambers became contaminated. These chambers served as a reservoir of the material, which was slowly dislodged by air expelled during subsequent handpiece operation and which was diluted by water spray used for cooling the drilling surface. Considering the fact that patient materials could reside in internal parts of the equipment that are not usually disinfected and that the material may be subsequently sprayed into cuts and abrasions in the oral cavity, the common approach to reprocessing handpieces (external wiping in combination with flushing) may pose unacceptably high risks to those individuals treated soon after infected patients. Therefore, unless reliable data on cross-infection frequencies are obtained and prove it unnecessary, heat-treating high-speed handpieces between each patient should be considered an essential component of standard procedures whenever universal precautions are practiced in dentistry.

Treating Soil Solution Samplers To Prevent Microbial Removal of Analytes

Soil microorganisms colonizing soil water sampling devices (lysimeters) reduced concentrations of biodegradable organic chemicals, including 2,4-dichlorophenoxyacetic acid methyl ester, alachlor, methyl m -chlorobenzoate, and metolachlor as water entered through porous ceramic cups. In some cases, losses exceeded 99%. Additions of either a biocide (sodium hypochlorite) or a bacteriostat (copper salt) prevented microbial activity so that concentrations of test chemicals inside lysimeters equaled those outside. Field studies further indicated that treating lysimeters with a copper salt effectively prevented microbial activity. Thus, chemically treating soil water samplers could improve the accuracy of soil water data for a wide variety of analytes, including environmentally important organics, such as pesticides and industrial wastes, and inorganics, such as ammonia and nitrate.